Fujimoto S, Shrestha R D, Kokubun M, Kobayashi K, Kiuchi S, Konno C, Okui K
First Department of Surgery, School of Medicine, Chiba University, Japan.
Nihon Geka Gakkai Zasshi. 1990 Feb;91(2):201-5.
Six patients with peritoneal recurrence after radical operation for gastric cancer were treated by an intraperitoneal hyperthermic perfusion (IPHP) combined with surgery (IPHP group). Immediately after surgery, a 2-hour IPHP was performed, using a perfusate containing 10 micrograms/ml of MMC, warmed at the inflow temperature of 46.5 +/- 1.1 degree C. Within the same period of time, 5 patients with intra-abdominal recurrent gastric cancer (control group) were treated by an intraperitoneal administration of MMC 10 mg combined with surgery. These 11 patients had malignant peritoneal effusion and, although in 3 of the control group, ascitic effusion did re-accumulate rapidly soon after surgery, the 6 patients of IPHP group did not re-accumulate post-hyperthermically. The average survival duration of IPHP group is 13.6 +/- 10. 6 months, whereas that for controls is 3.0 +/- 2.1 months. Again, the survival rate for IPHP group surpassed that for controls at p = 0.012 and p = 0.008, in a generalized Wilcoxon method and Logrank method, respectively. Post-hyperthermically, hypoproteinemia and thrombocytopenia occurred transitorily. These results show that IPHP using MMC combined with surgery is a safe, reliable treatment for patients with peritoneal recurrence due to gastric cancer.
6例胃癌根治术后腹膜复发患者采用腹腔热灌注（IPHP）联合手术治疗（IPHP组）。术后立即进行2小时的IPHP，使用含10微克/毫升丝裂霉素（MMC）的灌注液，入流温度加热至46.5±1.1℃。同期，5例腹腔内复发性胃癌患者（对照组）采用腹腔注射10毫克MMC联合手术治疗。这11例患者均有恶性腹腔积液，虽然对照组中有3例术后腹水很快再次迅速积聚，但IPHP组的6例患者热灌注后未再积聚。IPHP组的平均生存时间为13.6±10.6个月，而对照组为3.0±2.1个月。同样，在广义Wilcoxon法和Logrank法中，IPHP组的生存率分别在p = 0.012和p = 0.008时超过对照组。热灌注后，出现短暂性低蛋白血症和血小板减少症。这些结果表明，MMC联合手术的IPHP是治疗胃癌腹膜复发患者的一种安全、可靠的方法。
